Brief Biography
John Gunder Gunderson was born in 1942 in Two Rivers, Wisconsin, a town on Lake Michigan about 50 miles south of Green Bay.
Gunderson earned his bachelor’s degree in 1963 from Johns Hopkins University in Baltimore, Maryland.
Gunderson then received a Master’s of Biomedical Sciences (MBS) degree in 1965 from Dartmouth College’s Medical School in 1965.
Gunderson went on to obtain his MD in 1967 from Harvard Medical School in Cambridge, Massachusetts.
Upon receiving his MD, in 1967, Gunderson was appointed an Intern in Medicine at Hennepin County General Hospital in Minneapolis, Minnesota.
For the next four years, Gunderson served out his period of residency, first in Minnesota, then back in Massachusetts, where he was initially appointed Resident in Psychiatry and later Chief Resident in Psychiatry at the Massachusetts Mental Health Center in Boston.
In 1971, Gunderson was a Visiting Candidate at Washington Psychoanalytic Institute, Research Fellow at the Center for Studies of Schizophrenia, Psychiatric Assessment Section of the National Institute of Mental Health, and at the Chestnut Lodge Sanitarium. He was a Resident at Boston Psychoanalytic Institute between 1969 and 1980.
Gunderson was a pioneer in the study and treatment of borderline personality disorder (BPD). It was largely thanks to his efforts that during the past couple of generations BPD has become widely recognized as a distinctive category of mental illness requiring its own specific type of intervention.
Gunderson is also famous for his widely used therapeutic protocol, known as “Good Psychiatric Management (GPM),” for the treatment of BPD. GPM provides a set of guidelines to assist non-specialist mental health providers in the therapeutic management of patients suffering from BPD and related disorders.
Gunderson was appointed leader of the editorial team which revised the article on personality disorders for the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (1994).
At the time of his death in 2019 at the age of 76, Gunderson was Professor of Psychiatry at Harvard University, as well as Director of the Borderline Center at McLean Hospital, a psychiatric hospital in the Boston suburb of Belmont.
Gunderson was an accomplished athlete who fished, gardened, golfed, and played basketball into his seventies. He was also a talented amateur painter.
In 2009, the McLean Hospital named a treatment center the “Gunderson Residence” in his honor. The walls of the Residence were hung with many of Gunderson’s own paintings.
Altogether, Gunderson published around 300 peer-reviewed journal articles, book chapters, and reviews, as well as authoring, co-authoring, or co-editing some dozen books, including the highly popular textbook Borderline Personality Disorder (first edition 1984; second edition 2008, under the title Borderline Personality Disorder: A Clinical Guide, with Paul S. Links).
Notable Quotes
Basic BPD Training for All Psychiatrists
All psychiatrists should get an introduction, at least, and basic training about [BPD]. That by itself will get rid of some of the stigma.
“BPD: What Every Psychiatrist Should Know,” BorderlinerNotes, April 19, 2017.
[M]odern psychiatrists should know that these are people who have enormous pain, that there’s a heavy genetic loading to how they develop these problems. They should know that they can improve, most of them, even in the absence of any kind of intensive treatment that is designed specifically for borderline patients—with good support. they’ll get a lot better. So, they can be very rewarding, and you don’t have to be a genius or an expert or do anything heroic to help them.
“BPD: What Every Psychiatrist Should Know,” BorderlinerNotes, April 19, 2017.
No matter where you go, you’re going to have patients with borderline personality disorder, as common, in your exposure to them. It would be better to be trained and prepared and knowledgeable, rather than untrained, scared, and avoidant.
“BPD: What Every Psychiatrist Should Know,” BorderlinerNotes, April 19, 2017.
Diagnosis of BPD
BPD patients are often misdiagnosed; for example, nearly 40 percent of people diagnosed as bipolar are, in fact, borderline. There is a heritability factor of about 67 percent. Interestingly, it is one of the few psychiatric illnesses that is not lifelong, with remission likely and relapses rare.
Beyond Borderline: True Stories of Recovery from Borderline Personality Disorder, edited by John G. Gunderson and Perry D. Hoffman (2016).
When someone is diagnosed with depression, you won’t hear them say, “I am depression.” This is equally unlikely with a patient diagnosed with anorexia or bipolar disorder or even schizophrenia. A rare few psychiatric conditions enjoy the pleasure of being both an adjective describing one’s mood or classification of behaviors and a noun—a label—to encompass all of who one is. Alcoholics. Addicts. And borderlines.
Beyond Borderline: True Stories of Recovery from Borderline Personality Disorder, edited by John G. Gunderson and Perry D. Hoffman (2016).
Feeling of Emptiness in BPD Patients
[I]t seems, listening to life histories, as if it’s something that developed as a result of a longstanding sense of being neglected, so that there’s an inner emptiness, like a hungry child who has not been fed enough.
“The BPD Diagnostic Criteria,” BorderlinerNotes, April 19, 2017.
Gunderson on Gunderson
When I was a resident, I was curious, fascinated, and a little bit terrified by the phenomenon of a group of patients which at that time weren’t diagnosed but who gave a great deal of difficulty to the nursing staff, to my fellow residents—our supervisors didn’t know how to help us very much—and I got introduced to a not-very-well-known literature about a group of people called “borderline”—at that time “borderline schizophrenic” or “borderline neurotic” or . . . atypical of a lot of things and not clearly having any center.
“Defining Borderline Personality Disorder (Part 1),” BorderlinerNotes, April 19, 2017.
And we did an overview which was called “Defining Borderline Patients,” published in 1975. That article transformed my career. I was suddenly thought to be a great expert on a group of patients that actually kind of scared the bejesus out of me. So, I got lots of referrals, lots of consultations, [was] asked to give talks, had anxiety attacks because I didn’t know what I was talking about, and then I got involved in doing research and did the work that defined the disorder and got it introduced into the classification system in 1980. So, that’s how I got into it. I got very well known on account of an expertise I didn’t have. And the work I did was more based on an effort to get some control and distance from a phenomenon that scared me.
So, that’s my mission now. I’m trying to get all psychiatric training programs to adopt a basic curriculum so that all trainees know the basics about this disorder and that they will be less frightened in their efforts to get involved and treat them.
“BPD: What Every Psychiatrist Should Know,” BorderlinerNotes, April 19, 2017.
Psychotropic Medications
I think that every modern psychiatrist should be aware that medications are adjunctive and not emphasize them and get unrealistic hopes associated with their prescription.
“BPD: What Every Psychiatrist Should Know,” BorderlinerNotes, April 19, 2017.
Treating Patients with BDP
[Treating patients with BDP] appeals to a lot of people who see themselves as good caretakers and really want to get into these relationships because they see borderline patients as sort of helpless waifs. That’s not necessarily something that works very well for them or for patients in the long run. Some of the people who get into it through that avenue get toughened up and learn that they have to hold patients accountable, and they have to be able to say things and do things that the patients aren’t going to welcome and thank them for. You have to combine kicks with your kisses. Both are necessary.
“What Makes a Good BPD Therapist,” BorderlinerNotes, April 19, 2017.
The best people from the beginning are people who go into this who have ability to say “no” to people, have self-confidence, whose lives are fulfilled enough so that their self-esteem is not going to rise and fall with the success of their patients. Those are the people who are best suited for doing well right from the start.
“What Makes a Good BPD Therapist,” BorderlinerNotes, April 19, 2017.
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